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Elder abuse prevalence and risk factors: findings from the Canadian Longitudinal Study on Aging

Abstract

Elder abuse (EA) is a pervasive problem with serious consequences. Previous population-based EA risk factor research has largely used cross-sectional designs that limit causal inferences, or agency records to identify victims, which threatens external validity. Based on a national, prospective, population-based cohort sample of older adults (nā€‰=ā€‰23,468) over a 3-year period from the Canadian Longitudinal Study on Aging, the current study sought to estimate the prevalence of EA and identify risk and protective factors. Past-year prevalence of any EA was 10.0%. Older adults with greater vulnerability related to physical, cognitive and mental health, childhood maltreatment and shared living were at higher EA risk, while social support was protective against EA. Older adults identifying as Black or reporting financial need were at heightened EA risk. This longitudinal, population-based study advances our understanding of EA risk/protective factors across several domains and informs the development of EA prevention strategies.

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Data availability

Please note that due to privacy and ethical/legal issues for the CLSA participants, data are only available from the CLSA (https://www.clsa-elcv.ca/) for researchers who meet the criteria for access to de-identified CLSA data.

Code availability

Custom code or mathematical algorithms were not used in the current study. However, please see Supplementary Information Appendix A for the SPSS-generated syntax underlying the analyses in this study.

References

  1. Centers for Disease Control and Prevention. Elder abuse surveillance: uniform definitions and recommended core data elements. https://www.cdc.gov/violenceprevention/pdf/ea_book_revised_2016.pdf. Accessed 5 January 2021.

  2. 2015 White House Conference on Aging. Final report. https://whitehouseconferenceonaging.gov/2015-whcoa-final-report.pdf. Accessed 5 January 2021.

  3. World Health Organization. World report on ageing and health. http://apps.who.int/iris/bitstream/10665/186463/1/9789240694811_eng.pdf?ua=1. Accessed 6 January 2021.

  4. National Reserach Council. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America (eds. R. J. Bonnie & R. B. Wallace) (National Academies Press, 2003).

  5. Yon, Y., Mikton, C. R., Gassoumis, Z. D. & Wilber, K. H. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob. Health 5, e147ā€“e156 (2017).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  6. Pillemer, K., Burnes, D., Riffin, C. & Lachs, M. S. Elder abuse: global situation, risk factors, and prevention strategies. Gerontologist 56, S194ā€“S205 (2016).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  7. Yunus, R. M., Hairi, N. N. & Choo, W. Y. Consequences of elder abuse and neglect: a systematic review of observational studies. Trauma Violence Abuse 20, 197ā€“213 (2019).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  8. Dong, X. Q. Elder abuse: systematic review and implications for practice. J. Am. Geriatr. Soc. 63, 1214ā€“1238 (2015).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  9. Lachs, M. S., Williams, C. S., Oā€™brien, S., Pillemer, K. A. & Charlson, M. E. The mortality of elder mistreatment. JAMA 280, 428ā€“432 (1998).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  10. Dong, X. & Wang, B. Incidence of elder abuse in a US Chinese population: findings from the longitudinal cohort PINE study. J. Gerontol. A Biol. Sci. Med. Sci. 72, S95ā€“S101 (2017).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  11. Dong, X. Associations between the differential definitions of elder mistreatment and suicidal ideation outcomes in US Chinese older adults: do the definitions matter? J. Gerontol. A Biol. Sci. Med. Sci. 72, S82ā€“S89 (2017).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  12. Mouton, C. P., Rodabough, R. J., Rovi, S. L., Brzyski, R. G. & Katerndahl, D. A. Psychosocial effects of physical and verbal abuse in postmenopausal women. Ann. Fam. Med. 8, 206ā€“213 (2010).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  13. Fisher, B. S., Zink, T. & Regan, S. L. Abuses against older women: prevalence and health effects. J. Interpers. Violence 26, 254ā€“268 (2011).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  14. Lachs, M. S., Williams, C., Oā€™Brien, S., Hurst, L. & Horwitz, R. Risk factors for reported elder abuse and neglect: a nine-year observational cohort study. Gerontologist 37, 469ā€“474 (1997).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  15. Dong, X., Simon, M., Beck, T. & Evans, D. Decline in cognitive function and elder mistreatment: findings from the Chicago Health and Aging Project. Am. J. Geriatr. Psychiatry 22, 598ā€“605 (2014).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  16. Pillemer, K. & Finkelhor, D. The prevalence of elder abuse: a random sample survey. Gerontologist 28, 51ā€“57 (1988).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  17. Acierno, R. et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am. J. Public Health 100, 292ā€“297 (2010).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  18. Laumann, E. O., Leitsch, S. A. & Waite, L. J. Elder mistreatment in the United States: prevalence estimates from a nationally representative study. J. Gerontol. B Psychol. Sci. Soc. Sci. 63, S248ā€“S254 (2008).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  19. Burnes, D. et al. Prevalence of and risk factors for elder abuse and neglect in the community: a populationā€based study. J. Am. Geriatr. Soc. 63, 1906ā€“1912 (2015).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  20. Peterson, J. C. et al. Financial exploitation of older adults: a population-based prevalence study. J. Gen. Intern Med. 29, 1615ā€“1623 (2014).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  21. Chang, E. S. & Levy, B. R. High prevalence of elder abuse during the COVID-19 pandemic: risk and resilience factors. Am. J. Geriatr. Psychiatry 29, 1152ā€“1159 (2021).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  22. Burnes, D. et al. Exploring risk of elder abuse revictimization: development of a model to inform community response interventions. J. Appl. Gerontol. https://doi.org/10.1177/0733464820933432 (2020).

  23. Pillemer, K., Burnes, D. & MacNeil, A. Investigating the connection between ageism and elder mistreatment. Nat. Aging 1,159ā€“164 (2021).

  24. McDonald, L. & Thomas, C. Elder abuse through a life course lens. Int. Psychogeriatr. 25, 1235ā€“1243 (2013).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  25. McDonald, L. The mistreatment of older Canadians: findings from the 2015 national prevalence study. J. Elder Abuse Negl. 30, 176ā€“208 (2018).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  26. Chen M. & Fu, Y. Adverse childhood experiences: are they associated with greater risk of elder abuse victimization? J. Interpers. violence. Preprint at https://doi.org/10.1177/08862605211028328 (2021).

  27. Asyraf, M. et al. The association between elder abuse and childhood adversity: a study of older adults in Malaysia. PLoS ONE 16, e0254717 (2021).

    ArticleĀ  CASĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  28. Glendenning, F. What is elder abuse and neglect? in The mistreatment of elderly people (eds. P. Decalmor & F. Glendenning) 1ā€“34 (Sage, 1993).

  29. Statistics Canada 2021. Population estimates on July 1, by age and sex. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000501. Accessed 15 November 2021.

  30. Acierno, R. Elder mistreatment: epidemiological assessment methodology. In Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America (eds. R. J. Bonnie & R. B. Wallace) 259ā€“302 (National Academies Press, 2003).

  31. Storey, J. E. Risk factors for elder abuse and neglect: a review of the literature. Aggress. Violent Behav. 50, 101339 (2020).

    ArticleĀ  Google ScholarĀ 

  32. Ogle, C. M., Rubin, D. C. & Siegler, I. Cumulative exposure to traumatic events in older adults. Aging Ment. Health 18, 316ā€“325 (2014).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  33. Burnes, D., Pillemer, K. & Lachs, M. S. Elder abuse severity: a critical but understudied dimension of victimization for clinicians and researchers. Gerontologist 57, 745ā€“56. (2017).

    PubMedĀ  Google ScholarĀ 

  34. Rickwood, D. J. & Braithwaite, V. A. Socialā€“psychological factors affecting help-seeking for emotional problems. Soc. Sci. Med. 39, 563ā€“572 (1994).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  35. Kahlon, M. K. et al. Effect of layperson-delivered, empathy-focused program of telephone calls on loneliness, depression, and anxiety among adults during the COVID-19 pandemic: a randomized clinical trial. JAMA Psychiatry 78, 616ā€“622 (2021).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  36. Hoyumpa G, et al. Medical student-led social phone calls with elder mistreatment victims: changes in loneliness, depression, and perspectives of aging. J. Am. Geriatr. Soc. https://doi.org/10.1111/jgs.17713 (2022).

  37. Beach, S. R., Schulz, R., Castle, N. G. & Rosen, J. Financial exploitation and psychological mistreatment among older adults: differences between African Americans and non-African Americans in a population-based survey. Gerontologist 50, 744ā€“757 (2010).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  38. Burnes, D., Hancock, D. W., Eckenrode, J., Lachs, M. S. & Pillemer, K. Estimated incidence and factors associated with risk of elder mistreatment in New York State. JAMA Netw. Open 4, e2117758 (2021).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  39. Yon, Y., Mikton, C., Gassoumis, Z. D. & Wilber, K. H. The prevalence of self-reported elder abuse among older women in community settings: a systematic review and meta-analysis. Trauma Violence Abuse 20, 245ā€“259 (2019).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  40. Brozowski, K. & Hall, D. R. Aging and risk: physical and sexual abuse of elders in Canada. J. Interpers. Violence 25, 1183ā€“1199 (2010).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  41. Podnieks, E. National survey on abuse of the elderly in Canada. J. Elder. Abuse Negl. 4, 5ā€“8 (1993).

    ArticleĀ  Google ScholarĀ 

  42. Beach, S. R. et al. Using audio computer-assisted self-interviewing and interactive voice response to measure elder mistreatment in older adults: Feasibility and effects on prevalence estimates. J. Off. Stat. 26, 507ā€“533 (2010).

    PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  43. Raina, P. et al. The Canadian Longitudinal Study on Aging (CLSA). Can. J. Aging 28, 221ā€“229 (2009).

  44. Raina, P., Wolfson, C., Kirkland, S. A. & Griffith, L. E. The Canadian Longitudinal Study on Aging (CLSA): Report on Health and Aging in Canada. Retrieved from https://ifa.ngo/wp-content/uploads/2018/12/clsa_report_en_final_web.pdf (2018).

  45. Raina, P. et al. Cohort profile: the Canadian Longitudinal Study on Aging (CLSA). Int. J. Epidemiol. 48, 1752ā€“1753 (2019).

  46. Raina, P., Wolfson, C. & Kirkland, S. Canadian Longitudinal Study on Aging: protocol. https://clsa-elcv.ca/doc/511. Accessed 5 January 2021.

  47. Burnes, D. et al. Prevalence of financial fraud and scams among older adults in the United States: a systematic review and meta-analysis. Am. J. Public Health 107, e13ā€“e31 (2017).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  48. Fillenbaum, G. G. & Smyer, M. A. The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. J. Gerontol. 36, 428ā€“434 (1981).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  49. Subramanian, S. V., Huijts, T. & Avendano, M. Self-reported health assessments in the 2002 World Health Survey: how do they correlate with education? Bull. World Health Organ. 88, 131ā€“138 (2010).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  50. Schmidt, M. Rey Auditory Verbal Learning Test: a handbook (Western Psychological Services, 1996).

  51. Teng, E. The Mental Alternations Test. Clin. Neuropsychologist 9, 287 (1995).

    Google ScholarĀ 

  52. Ahmad, F., Jhajj, A. K., Stewart, D. E., Burghardt, M. & Bierman, A. S. Single-item measures of self-rated mental health: a scoping review. BMC Health Serv. Res. 14, 398 (2014).

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  53. Andresen, E. M., Malmgren, J. A., Carter, W. B. & Patrick, D. L. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am. J. Prev. Med. 10, 77ā€“84 (1994).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  54. Diener, E., Emmons, R. A., Larsen, R. J. & Griffin, S. The satisfaction with life scale. J. Pers. Assess. 49, 71ā€“75 (1985).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  55. Prins, A. et al. The Primary Care PTSD screen (PC-PTSD): development and operating characteristics. Primary Care Psychiatry 9, 9ā€“14 (2003).

    ArticleĀ  Google ScholarĀ 

  56. Walsh, C. A. et al. Measurement of victimization in adolescence: development and validation of the Childhood Experiences of Violence Questionnaire. Child Abuse Negl. 32, 1037ā€“1057 (2008).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  57. Tanaka, M. et al. Preliminary evaluation of the Childhood Experiences of Violence Questionnaire Short Form. J. Interpers. Violence 27, 396ā€“407 (2012).

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  58. Felitti, V. J. et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. Am. J. Prev. Med. 14, 245ā€“258 (1998).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  59. Sherbourne, C. D. & Stewart, A. L. The MOS social support survey. Soc. Sci. Med 32, 705ā€“714 (1991).

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

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Acknowledgements

This research was made possible using the data/biospecimens collected by the CLSA. Funding for the CLSA is provided by the Government of Canada through the Canadian Institutes of Health Research under grant reference LSA 94473 and the Canada Foundation for Innovation, as well as the provinces of Newfoundland, Nova Scotia, Quebec, Ontario, Manitoba, Alberta and British Columbia. This research was conducted using the CLSA Baseline Tracking Dataset version 3.5, Comprehensive Dataset version 4.1, Follow-up 1 Tracking Dataset version 2.1, Comprehensive Dataset version 3.0 under application ID 1906012. The CLSA is led by P. Raina, C. Wolfson and S. Kirkland. The opinions expressed in this paper are the authorsā€™ own and do not reflect the views of the CLSA. This project received funding from the Public Health Agency of Canada (4500415616, to D.B.). The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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D.B. was involved in study conceptualization, data cleaning, data analysis, findings interpretation and manuscript writing/editing. K.P., T.R. and M.S.L. were involved in study conceptualization, findings interpretation and manuscript writing/editing. L.M. was involved in study instrument development, findings interpretation and manuscript writing/editing.

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Correspondence to David Burnes.

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Nature Aging thanks Ronald (E) Acierno, Kathleen Wilber, and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Supplementary Table 1 and SPSS data analysis code

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Burnes, D., Pillemer, K., Rosen, T. et al. Elder abuse prevalence and risk factors: findings from the Canadian Longitudinal Study on Aging. Nat Aging 2, 784ā€“795 (2022). https://doi.org/10.1038/s43587-022-00280-2

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